Uterine prolapse occurs when pelvic floor muscles and ligaments stretch and weaken, providing inadequate support for the uterus. The uterus then descends into or protrudes from the vagina. Uterine prolapse can happen to women of any age, but it often affects postmenopausal women who've had one or more vaginal deliveries. Damage to supportive tissues during pregnancy and childbirth, effects of gravity, loss of estrogen, and repeated straining over the years all can weaken the pelvic floor and lead to uterine prolapse.
At the present time, sacral colpopexy is the gold standard procedure for post-hysterectomy patients who have vaginal vault prolapse. Patients who still have their uterus and are undergoing sacral colpopexy are having a total hysterectomy or a supracervical hysterectomy at the same time. This can lead to mesh erosion. The only reason that most hysterectomies are performed is because the appropriate mesh that can provide anterior, posterior, and apical uterine support is not available. Hysteropexy is the surgical fixation of a displaced uterus. The hysteropexies that are performed at the present time are either supporting the uterus by placing the mesh anteriorly or posteriorly.